The WHO Model List of Essential Medicines is currently used by more than 150 countries worldwide and serves as a model for countries to develop their own national lists, based on local disease burden and existing healthcare delivery infrastructure. Governments use (national) essential medicines lists to facilitate sustainable, equitable access to medicines and diagnostics tests and promote their appropriate use. Medicines included in the list are ‘those that satisfy the priority healthcare needs of the population, selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness.’
Since 1977 the WHO EML is updated and revised every two years by the WHO Expert Committee on Selection and Use of Medicines. In the list are included information on available dose forms, specifications about the medicine indication and the treatment setting, as well as details about the clinical evidence supporting recommendations being made. The EML section (and sub-sections) of relevance to oncology is ‘8.2 Antineoplastic and supportive medicines’. Since February 2020 the list is also available in an electronic version, the eEML, which combines detailed data on the medicine (indication, dosage, etc.) with comprehensive information on evaluation of benefits, arms and costs (e.g. effectiveness, safety, implications for health care systems).
From 2019, “the Committee acknowledged the role of the ESMO-Magnitude of Clinical Benefit Scale (ESMO–MCBS) as a screening tool to identify cancer treatments that have potential therapeutic value that warrants full evaluation for EML listing. Potential new EML cancer medicines, in general, should have a score on the ESMO-MCBS of A or B in the curative setting and of 4 or 5 in the non-curative setting. These scores would support a medicine being evaluated by the Expert Committee for inclusion in the EML through a full application”.
To find out more about the role of the ESMO-MCBS in the WHO Essential Medicines List, check out the WHO Report!
Selection of essential medicines at country level
In March 2020 the WHO has published a Guide on the ‘Selection of Essential Medicines at Country Level: Using the WHO Model List of Essential Medicines to update a national essential medicines list’. The guide provides information on how to update your national essential medicines list and how countries should select essential medicines, with the role of the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) mentioned in that process (page 25).